I recently had need to change a patients oral contraceptive from Loestrin 20 up to Loestrin 30. I explained that the increased strength may have effects aside from the desired reason for increasing it, and incorrectly joked about her “growing a beard”…

…off she went….

A few days later she was back. Explaining that she actually had needed to shave and pluck her facial hair for several months, and was there something I could do to lessen her problem.

My observation skills were not at there best!

Phew I thought, my warped sense of humour actually prompted someone to address an embarrassing condition and feel relaxed enough to discuss it with me.

I asked her if she had a facial hair problem prior to using the contraceptive pill. She wasn’t which started first facial hair or oral contraceptive. I actually said:

“So it was a close drawn thing” What I very nearly said and just managed to stop myself was:

“So it was a close shave between which was first”. Again I managed to get away from my usual foot in mouth attack.

But it isn’t just me that is effected by saying the wrong thing.

I had a patient come in 1 week post vasectomy, stating he was concerned as one of the wounds from his surgery had a “ball hanging out”.

Oh my god! It’s supposed to be keyhole surgery. I had vision of a gaping pus filled scrotal wound with a testicle hanging out. (Yes – my mind is so warped I can easily conjure up such images).

Thankfully what I actually saw was a neat scar, with a small area of granulated tissue – Phew what a relief!

I was sitting peacefully one evening, talking to my wife and sister in law (both work in a large hospital), when one of them piped up that one of the girls at work had mentioned a “new superbug”. All three of us reacted in the same way when we heard the name of this new threat to human life….

“but that’s been around for years!”

But sure enough I go to the reliable “Telegraph” and find only this week an article entitled:

Even someone who doesn’t remember the ward sisters ensuring the water in the flowers was changes daily to stop Pseudomonas growing, could have guessed there was something slightly amiss with the definition “new”.

The article includes an interview with Professor Enright who estimates that pseudomonas kills hundreds each year, particularly those patients who go on to get septicaemia, or blood poisoning….Whoa!!! Hold on there!!! If it’s so new how come it kills hundreds each year, it must have been around a while to know that!

Then the article goes on to say it isn’t officially classed as a superbug….So it’s not new and…

it’s not a superbug….Inaccurate headline then really. Still I suppose:

“Old bug most clinical staff have heard of, maybe killing hundreds” Doesn’t have the same punchy scaremongery ring about it.

So how old is this “new bug”. Well that great non medical web site wikipedia states:

The generic name Pseudomonas created for these organisms was defined in rather vague terms in 1894 as a genus of Gram-negative, rod-shaped and polar-flagella bacteria.

The Guardian gives us a hint…stating that: The number of cases of Pseudomonas rose by 41 per cent from 2,605 in 2002 to 3,663 last year, according to Health Protection Agency figures.

Now that is something to worry about….statistics, they always scare me. 86% of statistics are made up on the spot, while 94% are based on research carried out by incompetent government aids!

Lets look closer at those scary numbers…firstly forget the percentages. From 2,605 cases in 2002 to 3,663 cases in 2006. That’s 1,058 cases. Any increase in a life threatening bacteria is obviously a bad thing – I don’t dispute it. But let us put the percentage back in…

UK population is estimate around 60,587,000….therefore that’s an increase of 0.0017% of the whole UK population in four years.

It doesn’t take a genius to realise that even in a government funded health service that money is a key factor to pretty much everything…

…whether we like it or not.

General Practitioners across the UK state they are struggling to fund the running of their surgeries let alone their sports cars! So it wouldn’t be too much of a surprise if large corporate service providers offered location and funding. What am I gabbling on about?…

I get the feeling that on hearing this people will be deeply concerned. But I find the prospect quite interesting. Two things sprang to that daft head of mine. Firstly all the times I’ve heard demoralised nurses saying they would leave nursing and get a job stacking shelves – soon they can, but still work in the same building! Secondly could they find many people willing to take the job description of “Virgin Nurse”?

Virgin Staff Nurse? Surely a myth!

These simple concerns aside, other issues come to mind. From a closer look a “spokesman” said:

“patients in the city had complained of issues such as opening hours, cleanliness and telephone access, all of which would be standardised in purpose-built centres, instead of the current situation of “Victorian terraces where people are practising medicine in the back room””.

Now to my mind most surgeries are purpose built and since Shipman, the one doctor squeezed into a back room has become less and less evident. Would these new surgeries just be run by the big corperate names, or actually run in there stores?

I have visions of my consulting room being inside the supermarket…

“Well Mr Jones, it seems you have piles, that reminds me I must just pop out and get some grapes”

Regreting not putting gloves on!

“Ah Miss Smith, sounds like a case of Vaginal Thrush, hmm, perhaps I’ll put that cream cheese back on the shelf”

“Yes Mrs Davies, Breast feeding can lead to mastitis, the Savoy cabbages are on Aisle 3″

Not a lovely pair of cabbages!

Silliness aside (who me?), I think it is an interesting proposal, lets face it nobody can manage a GP budget very well at present, perhaps a large company would do it better, open at more convienient times and in more convienient places.

My concerns however would be that Tesco’s is the Devils supermarket, they focus strictly on profit. They trash the competition by making everything ridiculously cheap, and force the farmers to produce everything cheaper or loose their contracts. So how would they treat the common all garden GP surgery? Sure the club card points might pay for the patients petrol, but would they squeeze the very life out of the surgery, less people doing more work, and my biggest concern….

Jai was saying that she had recently watched a documentary about global health threats. The end of it focused on the latest threat to global health, specifically diabetes and obesity. The projected figures for the cost of diabetes and all associated care was HUGE.

“These patients of the future will bleed the system, and overtake it like locusts feeding off the resources outnumbering the regular sick people. The very worst part is the WHO have no real plan”.

So after this discussion that worrying Max brain got ticking….

Any second now…..he thought….

What is likely to happen? Well, the UK Government may well take the same approach they took to cigarettes : firstly big labels.